High background Troponin levels

[Rosey666]

Hi, I am new here but I have been a member for a while and I had a STEMI six years ago with a Troponin level of 980 and several more NSTEMI since with Troponin levels of 50 plus. I had a Syncope (blackout) four years ago with constant Ectopic beats ever since for which I have been treated with Amiodarone after other medication failed to help. Because Amiodarone is a toxic drug the dose I take was reduced three months ago which resulted in my Thyroid function becoming over active.

Two weeks ago I rang NHS 111 because I had chest pain and was taken to hospital where they did an ECG and Troponin tests, my ECG didn’t show anything abnormal (no surprise because it never does) but my Troponin level rose from 168 to 170 in two hours so I was told to wait for a bed and I would be admitted. After a six hour wait I was told that I hadn’t had an MI so I was being sent home, I asked about the raised Troponin levels and was told by a very unsympathetic Consultant that I couldn’t have a heart problem because I can walk for 30 minutes daily.

I had an appointment with my GP the next day and I showed her the discharge summary from the previous day, she promptly sent me back to hospital because of the Troponin levels and symptoms, they duly admitted me and my Troponin levels had gone up to 172. The consensus was that I should have another Angiogram (my fifth to date) but this showed no obstructions and my previous three stents were healthy. My dose of Amiodarone was removed to see if my Thyroid becomes normal again but that will probably take a few months, I fear that the arrhythmia has already returned though and there are no other drugs available apparently, Amiodarone is effectively the last resort.

I was discharged the next day with no real explanation of my elevated Troponin levels other than “some people are like this” and my GP knows less than the Cardiac team so I am baffled.

My understanding of Troponin levels is that the enzyme is released by the heart when it is damaged, how can the levels be elevated without damage?

I am obviously fearful of the future because nobody I have met has an explanation for me, has anyone else experienced this problem?

Sorry for the long post but apparently I am a ‘complex case’

[FiftyNotOut]

I don’t know about the rest, but if being able to walk for 30 minutes a day was the measure of whether or not you have a heart problem, most of us on here would be said to not have a heart problem. I’m assuming they weren’t a cardiologist. Barely a Dr by the sound of it.

[Milkfairy Heart Star]

HappyJo has given you good advice already.

Troponin levels can be raised for other reasons such as arrthymias, inflammation, infection, kidney problems, blood clots, extreme exercise and following coronary vasospasms.

I can exercise, even have clear coronary arteries however because my coronary blood vessels have a habit of going into temporary, transient spasms and constrictions, I have angina.

I suggest you ask to be assessed for all the possible causes of your raised Troponin levels including non obstructive coronary artery disease.

[Simes11]

Troponin levels can also be raised due to pulmonary or thyroid issues (both of which are two of the MANY serious side effects of Amiodarone) as well as systemic inflammation. Have you had your CRP checked lately?

[richard_jw]

Looking at BHF website,

"For many people, amiodarone-related thyroid effects can be treated with medication to control thyroid function, but some may need to stop taking the drug. If this happens, dronedarone, which is structurally similar to amiodarone, may be substituted as it has no adverse effects on thyroid function."